$15 million funds research to help older adults prevent cognitive decline?

IMAGE: Eric J. Lenze, M.D., and colleagues at Washington University School of Medicine have received a $15 million grant to study how exercise, health education, meditation and yoga might prevent or...
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Credit: Robert Boston

A five-year, $15 million grant from the National Institute on Aging, of the National Institutes of Health (NIH), is funding research into strategies -- including exercise, health education, meditation and yoga -- aimed at helping older adults prevent or reverse typical age-related cognitive decline.

Led by principal investigator, Eric J. Lenze?, MD, the team includes 14 researchers at Washington University School of Medicine in St. Louis in fields as diverse as psychiatry, medicine, radiology, neurology, biostatistics, physical therapy and occupational therapy. Faculty from the university's psychology department in the College of Arts & Sciences also are involved.

They plan to recruit 580 people over age 65 who have significant problems with thinking and memory but do not have dementia caused by conditions such as Alzheimer's disease.

"We're seeking people who are noticing that, as they've aged, their memories or concentration aren't as sharp as they used to be, people who do not have dementia but are living in the community and are otherwise healthy," explained Lenze, a professor of psychiatry.

Most people experience a peak in cognitive performance in their 30s. After that, cognition declines with increasing age, Lenze said. Older people still may test within the normal ranges for their age groups, but their cognitive abilities won't be as sharp as they were earlier in life. The question is whether this decline might be prevented or reversed.

Study volunteers are evaluated with a series of cognitive tests that ask them to remember a list of words or a brief story, write down a series of numbers, or alternate between different thoughts or ideas. They also receive MRI scans to show brain structure and how the brain functions during prescribed activities and rest.

After the screenings are complete, subjects are placed randomly into one of four study groups. Participants in one group receive a health education intervention that teaches them how to manage their medications, communicate effectively with their doctors and improve behavior to promote overall health.

Members of a second group are asked to exercise regularly and participate in a weekly aerobic exercise and resistance-training program.

Participants in a third group receive mindfulness training, including meditation, yoga and various techniques designed to help them learn how to remain focused on the moment. And members of a fourth group engage in exercise and mindfulness training.

"Everyone in the study receives one or more of these interventions," Lenze said. "We'll be trying to determine which intervention is most helpful and who benefits most."

Earlier research by Lenze looked at some of these interventions as potential treatments for anxiety and depression in older adults.

"Preliminary work we did showed there were cognitive benefits in some older adults," he said. "It may be that older adults with the greatest levels of stress -- measured not just by how they feel but also by biological indicators -- are the most likely to get cognitive benefits from these interventions."

Those in the study are to receive an intervention for six months, and during that time, come to the School of Medicine weekly. After that, they'll be followed for another year, with monthly visits required.

Lenze said that marathon-running yoga teachers need not apply for this study.

"We're looking for volunteers who aren't in a regular exercise program and are not currently engaged in mindfulness training or in a health education program," he said.

In addition to the Washington University researchers, a similar study group will recruit volunteers at the University of California, San Diego to test the same interventions.

Washington University School of Medicine's 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient-care institutions in the nation, currently ranked sixth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC HealthCare.

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